A Quebec man suffering from body integrity identity disorder (BIID) asked a doctor to remove the fourth and fifth fingers on his left hand because he felt they didn’t belong on his body.

Dr. Nadia Nadeau from the Department of Psychiatry at Université Laval recently published a case report about an unnamed patient who had been experiencing traumatizing thoughts that the last two fingers on his left hand didn’t belong on his body since childhood. Throughout his life, these thoughts caused him pain, constant irritability, impaired dexterity, and vivid nightmares that the two fingers were rotting or burning. Although the patient did not share his distress about his fingers with his family out of embarrassment, he often fantasized about having them removed himself.

Photo: Andrik Langfield/Unsplash

“Working in a sawmill, he considered building a small guillotine to cut his fingers,” Dr. Nadeau wrote. “He was aware self-harm wasn’t a safe solution and could have repercussions on his relationships, reputation, and health. He couldn’t imagine himself living for the years to come with those fingers.”

Because the man’s brain imaging looked normal, he was offered non-invasive treatment options like cognitive behavioral therapy, antidepressants, antipsychotics, and exposure therapy, but none of them proved successful. Following a psychiatric evaluation, the patient was deemed capable of requesting a voluntary amputation and referred to the orthopedic department. It was ultimately decided that the removal of the two fingers was the best way to help the patient, and an evaluation six months after the amputation confirmed it.

“Post-surgery, nightmares stopped immediately, along with the emotional distress,” the psychiatrist wrote. “He had constructive life plans, reduced anger, and improved well-being with family and at work. No regrets were expressed. He is now living a life free from distressing preoccupations about his fingers, with all his symptoms related to BID resolved. The amputation enabled him to live in alignment with his perceived identity.”

 

Body integrity identity disorder (BIID) is an extremely rare condition characterized by a strong and persistent desire to acquire a disability. Over a decade ago, we wrote about a healthy woman who dreamed of becoming paralyzed from the waist down and lived like a paraplegic, moving around in a wheelchair and wearing long metal braces that locked at the knees.